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Big doubt > Post-chemo RPLND versus Surveillance

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  • #16
    To me the b-hCG does not appear that elevated that I would be overly worried solely on the lab level. A low testosterone situation could be occurring after chemo and a testosterone challenge may show those numbers drop. Of concern to me would be what the inguinal nodes are indicating. Has he had prior scrotal/groin surgery on that side before the TC? If so then the inguinal involvement may be more TC related but wondering it is could be related to something else and confusing the situation?

    Post-chemo I think more experts would recommend an open, bilateral RPLND and not a selective node dissection. The question again would be is there inguinal involvement. Simultaneous RPLND and pelvic lymph node dissections are done but not all that common. Memorial Sloan Kettering has published on their data to give some perspective:

    Oct. 2005 felt lump but waited over 7 months.
    06.15.06 "You have Cancer"
    06.26.06 Left I/O
    06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
    06.30.06 It's Official - Stage I Seminoma
    Founded the Testicular Cancer Society
    6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

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